Area-level inequalities in Covid-19 outcomes in Brazil in 2020 and 2021: An analysis of 1,894,165 severe Covid-19 cases

Detalhes bibliográficos
Autor(a) principal: Boing, Antonio Fernando
Data de Publicação: 2022
Outros Autores: Boing, Alexandra Crispim, Veras, Maria Amélia, de Lacerda, Josimari Telino, da Silva, Rafael Lopes Paixão, Barbato, Paulo Roberto, Fabrin, Caroline, Subramanian, S. V.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UNESP
Texto Completo: http://dx.doi.org/10.1016/j.ypmed.2022.107298
http://hdl.handle.net/11449/248985
Resumo: The study aims to analyze inequalities in Covid-19 outcomes in Brazil in 2020/2021 according to the per capita Gross Domestic Product (pcGDP) of municipalities. All cases of Severe Acute Respiratory Syndrome (SARS) who were hospitalized or died, regardless of hospitalization, registered in Brazil in 2020 and 2021 were analyzed (n = 2,902,742), including those with a confirmed diagnosis of Covid-19 (n = 1,894,165). We calculated lethality due to Covid-19, the performance of diagnostic tests among patients with SARS, and the hospital care received by those with Covid-19 according to the pcGDP of the patients' municipalities of residence. Data were analyzed for each epidemiological week and the risk of each outcome was estimated using Poisson regression. Municipalities in the lowest pcGDP decile had (i) 30% (95%CI 28%–32%) higher lethality from Covid-19, (ii) three times higher proportion of patients with SARS without the collection of biological material for the diagnosis of Covid-19, (iii) 16% (95%CI 15%–16%) higher proportion of SARS patients testing in a period longer than two days from the onset of symptoms, (iv) 140% (95%CI 134%–145%) higher absence of CT scan use. There is deep socioeconomic inequality among Brazilian municipalities regarding the occurrence of Covid-19 negative outcomes.
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spelling Area-level inequalities in Covid-19 outcomes in Brazil in 2020 and 2021: An analysis of 1,894,165 severe Covid-19 casesCOVID-19EpidemiologyInequalities in healthThe study aims to analyze inequalities in Covid-19 outcomes in Brazil in 2020/2021 according to the per capita Gross Domestic Product (pcGDP) of municipalities. All cases of Severe Acute Respiratory Syndrome (SARS) who were hospitalized or died, regardless of hospitalization, registered in Brazil in 2020 and 2021 were analyzed (n = 2,902,742), including those with a confirmed diagnosis of Covid-19 (n = 1,894,165). We calculated lethality due to Covid-19, the performance of diagnostic tests among patients with SARS, and the hospital care received by those with Covid-19 according to the pcGDP of the patients' municipalities of residence. Data were analyzed for each epidemiological week and the risk of each outcome was estimated using Poisson regression. Municipalities in the lowest pcGDP decile had (i) 30% (95%CI 28%–32%) higher lethality from Covid-19, (ii) three times higher proportion of patients with SARS without the collection of biological material for the diagnosis of Covid-19, (iii) 16% (95%CI 15%–16%) higher proportion of SARS patients testing in a period longer than two days from the onset of symptoms, (iv) 140% (95%CI 134%–145%) higher absence of CT scan use. There is deep socioeconomic inequality among Brazilian municipalities regarding the occurrence of Covid-19 negative outcomes.Programa de Pós-graduação em Saúde Coletiva Universidade Federal de Santa Catarina, SCFaculdade de Ciências Médicas da Santa Casa de São Paulo, SPInstituto de Física Teórica Universidade do Estado de São Paulo, SPUniversidade Federal da Fronteira Sul, Campus Chapecó, SCHarvard Center for Population & Development Studies Harvard UniversityUniversidade Federal de Santa Catarina (UFSC)Faculdade de Ciências Médicas da Santa Casa de São PauloUniversidade do Estado de São PauloUniversidade Federal da Fronteira SulHarvard UniversityBoing, Antonio FernandoBoing, Alexandra CrispimVeras, Maria Améliade Lacerda, Josimari Telinoda Silva, Rafael Lopes PaixãoBarbato, Paulo RobertoFabrin, CarolineSubramanian, S. V.2023-07-29T13:59:15Z2023-07-29T13:59:15Z2022-11-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://dx.doi.org/10.1016/j.ypmed.2022.107298Preventive Medicine, v. 164.1096-02600091-7435http://hdl.handle.net/11449/24898510.1016/j.ypmed.2022.1072982-s2.0-85139725242Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengPreventive Medicineinfo:eu-repo/semantics/openAccess2023-07-29T13:59:15Zoai:repositorio.unesp.br:11449/248985Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-05T21:50:16.274756Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false
dc.title.none.fl_str_mv Area-level inequalities in Covid-19 outcomes in Brazil in 2020 and 2021: An analysis of 1,894,165 severe Covid-19 cases
title Area-level inequalities in Covid-19 outcomes in Brazil in 2020 and 2021: An analysis of 1,894,165 severe Covid-19 cases
spellingShingle Area-level inequalities in Covid-19 outcomes in Brazil in 2020 and 2021: An analysis of 1,894,165 severe Covid-19 cases
Boing, Antonio Fernando
COVID-19
Epidemiology
Inequalities in health
title_short Area-level inequalities in Covid-19 outcomes in Brazil in 2020 and 2021: An analysis of 1,894,165 severe Covid-19 cases
title_full Area-level inequalities in Covid-19 outcomes in Brazil in 2020 and 2021: An analysis of 1,894,165 severe Covid-19 cases
title_fullStr Area-level inequalities in Covid-19 outcomes in Brazil in 2020 and 2021: An analysis of 1,894,165 severe Covid-19 cases
title_full_unstemmed Area-level inequalities in Covid-19 outcomes in Brazil in 2020 and 2021: An analysis of 1,894,165 severe Covid-19 cases
title_sort Area-level inequalities in Covid-19 outcomes in Brazil in 2020 and 2021: An analysis of 1,894,165 severe Covid-19 cases
author Boing, Antonio Fernando
author_facet Boing, Antonio Fernando
Boing, Alexandra Crispim
Veras, Maria Amélia
de Lacerda, Josimari Telino
da Silva, Rafael Lopes Paixão
Barbato, Paulo Roberto
Fabrin, Caroline
Subramanian, S. V.
author_role author
author2 Boing, Alexandra Crispim
Veras, Maria Amélia
de Lacerda, Josimari Telino
da Silva, Rafael Lopes Paixão
Barbato, Paulo Roberto
Fabrin, Caroline
Subramanian, S. V.
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidade Federal de Santa Catarina (UFSC)
Faculdade de Ciências Médicas da Santa Casa de São Paulo
Universidade do Estado de São Paulo
Universidade Federal da Fronteira Sul
Harvard University
dc.contributor.author.fl_str_mv Boing, Antonio Fernando
Boing, Alexandra Crispim
Veras, Maria Amélia
de Lacerda, Josimari Telino
da Silva, Rafael Lopes Paixão
Barbato, Paulo Roberto
Fabrin, Caroline
Subramanian, S. V.
dc.subject.por.fl_str_mv COVID-19
Epidemiology
Inequalities in health
topic COVID-19
Epidemiology
Inequalities in health
description The study aims to analyze inequalities in Covid-19 outcomes in Brazil in 2020/2021 according to the per capita Gross Domestic Product (pcGDP) of municipalities. All cases of Severe Acute Respiratory Syndrome (SARS) who were hospitalized or died, regardless of hospitalization, registered in Brazil in 2020 and 2021 were analyzed (n = 2,902,742), including those with a confirmed diagnosis of Covid-19 (n = 1,894,165). We calculated lethality due to Covid-19, the performance of diagnostic tests among patients with SARS, and the hospital care received by those with Covid-19 according to the pcGDP of the patients' municipalities of residence. Data were analyzed for each epidemiological week and the risk of each outcome was estimated using Poisson regression. Municipalities in the lowest pcGDP decile had (i) 30% (95%CI 28%–32%) higher lethality from Covid-19, (ii) three times higher proportion of patients with SARS without the collection of biological material for the diagnosis of Covid-19, (iii) 16% (95%CI 15%–16%) higher proportion of SARS patients testing in a period longer than two days from the onset of symptoms, (iv) 140% (95%CI 134%–145%) higher absence of CT scan use. There is deep socioeconomic inequality among Brazilian municipalities regarding the occurrence of Covid-19 negative outcomes.
publishDate 2022
dc.date.none.fl_str_mv 2022-11-01
2023-07-29T13:59:15Z
2023-07-29T13:59:15Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.1016/j.ypmed.2022.107298
Preventive Medicine, v. 164.
1096-0260
0091-7435
http://hdl.handle.net/11449/248985
10.1016/j.ypmed.2022.107298
2-s2.0-85139725242
url http://dx.doi.org/10.1016/j.ypmed.2022.107298
http://hdl.handle.net/11449/248985
identifier_str_mv Preventive Medicine, v. 164.
1096-0260
0091-7435
10.1016/j.ypmed.2022.107298
2-s2.0-85139725242
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Preventive Medicine
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eu_rights_str_mv openAccess
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reponame:Repositório Institucional da UNESP
instname:Universidade Estadual Paulista (UNESP)
instacron:UNESP
instname_str Universidade Estadual Paulista (UNESP)
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reponame_str Repositório Institucional da UNESP
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